Differentials and workups Flashcards

Question

Basic presentation, differential, and workup for vertigo?

Answer 1

BPPV (lasts minutes with movement) Menieres Disease (20min to hours w/hearing loss tinnitus, +/- N/V or drop attacks Acoustic neruoma (gradual onset +hearing loss) Vestibular neuritis (sudden onset +N/V, -hearing loss -tinnitus) Larynthitis (+N/V, +hearing loss, +tinnitus) Vertebrobasilar insufficiency (-hearing loss +focal neuro) ``` Dix-Hallpike manouver Epley manouver CBC Electrolytes MRI/MRA - brain Audiogram VDRL/RPR Electronystagmography ```

Answer 2

Conductive: Cerumen impaction Otosclerosis Otitis media Sensory: Auditory nerve damage Labrinthitis Acoustic neruoma Audiogram MRI - brain CT - head Weber lateralizes to good side in sensorineural loss Renne BC>AC in conductive loss on affected side

Answer 3

``` Generalized tonic-clonic seizure Drug-induced orthostatic hypotension Cardiac arrythmia Hypoglycemia Severe aortic stenosis Substance abuse ``` ``` CBC Electrolytes EEG ECG 24 hour Holter monitor Urine tox CT-head LP-CSF analysis MRI-brain Echocardiogram ```

Answer 4

``` Stroke TIA Seizure - Todd's paralysis Guillian-Barre Syndrome Myasthenia Gravis Lambert-Eaton CNS tumor Subdural or epidural hematoma MS ``` ``` CT - head MRI - brain CBC Electrolytes PT/PTT Carotid doppler EEG ECG Echocardiogram LP - CSF analysis B12 Tensilon test EMG ```

Answer 5

Retinal artery occlusion Retinal vein occlusion Acute angle-closure glaucoma ``` CBC Electrolytes PT/PTT Flourescein angiogram Carotid doppler Echocardiogram Intaocular tonometry ```

Answer 6

``` Major depression Bipolar I or II Bereavement Dysthymic disorder Hypothyroidism Substance abuse ``` Beck depression inventory Urine tox TSH

Answer 7

``` Depressed mood Anhedonia Changes in sleep Changes in appetite Trouble concentrating Decreased energy Psychomotor depression Feelings of guilt or worthlessness Thoughts of self harm ```

Answer 8

``` Alzheimer disease Vascular dementia Normal pressure hydrocephalus Lewy body dementia Anterofrontal dementia Depression (pseudodementia) Chronic subdural hematoma B12 deficiency Hypothyroidism Wernicke's Encephalopathy Delerium Intracranial neoplasm ``` ``` CBC Electrolytes TSH B12 VDRL/RPR CT - head LP - opening pressure, CSF analysis MRI - brain ```

Answer 9

``` Schizophrenia Schizophreniform disorder Schizoaffective disorder Psychotic disorder due to general medical condition Substance induced psychosis ``` ``` MSE Urine toxicology CBC Electrolytes TSH Beck depression inventory ```

Answer 10

``` Depression Hypothyroidism Cancer OSA DM II Anemia Narcolepsy Shift work sleep disorder ``` ``` Beck depression inventory TSH, fT3, fT4 CBC Electrolytes Urine toxicology Glucose tolerance test HbA1c Nocturnal Pulse ox Polysomnography ```

Answer 11

``` Viral pharyngitis Bacterial pharyngitis Mononucleosis Acute HIV infection Streptococcal tonsilitis Secondary syphilis Mycoplasma pneumonia Post nasal drip ``` ``` CBC w/ differential, and peripheral smear Electrolytes Throat culture HIV antibody Monospot test anit-EBV antibodies Rapid strep test ALT,AST,alkaline phosphatase, bilirubin VDRL/RPR Cold agglutinin for mycoplasma ```

Answer 12

``` Asthma Bronchitis GERD COPD (or exacerbation) Pneumonia Atypical pneumonia Lung cancer Tuberculosis Heart failure ``` ``` CBC Electrolytes Sputum gram stain, culture, and acid fast stain PFTs CXR ECG Echocardiogram BNP ```

Answer 13

``` MI PE Angina Pneumonia Aortic dissection Pericarditis Pleurisy Costochondritis Pneumothorax ``` ``` ECG CXR CBC Electrolytes CPK-MB + troponin x3 Echocardiogram d-dimer CT-chest CTA-chest US doppler LEs ```

Answer 14

``` Hyperthyroidism Hypoglycemia Cardiac arrhythmia Panic attack Pheochromocytoma Carcinoid syndrome Substance abuse ``` ``` CBC Electrolytes TSH, fT4 ECG Blood glucose 24 hour urine catecholamines 5-HIAA Urine toxicology ```

Answer 15

``` Hyperthyroidism DM Cancer HIV Tuberculosis Anorexia nervosa Malabsorption Substance abuse - dieting drugs ``` CBC Electrolytes, glucose TSH, fT4

Answer 16

``` Hypothyroidism Smoking cessation Drug side effect Cushing syndrome Polycystic ovarian syndrome DM Atypical depression ``` ``` CBC Electrolytes, glucos TSH 24 hour urine free cortisol Dexamethasone suppression test ```

Answer 17

Hodgkin's/Non-Hodgkin's lymphoma Tuberculosis Thyroid nodule Gastric carcinoma ``` CBC w/ differential Electrolytes ESR CRP PPD TSH CXR US thyroid Upper endoscopy ```

Answer 18

``` UTI Nephrolithiasis Bladder Ca RCC Acute glomerulonephritis Prostate Ca Coagulation disorder Pyelonephritis PKD ``` ``` Genitourinary exam UA, urine cytology BUN/Cr CBC Electrolytes PT/PTT US renal, bladder Cystoscopy CT - abdomen/pelvis PSA ```

Answer 19

``` BPH Prostate Ca UTI Bladder Stones RCC ``` ``` Genitourinary exam Rectal exam PSA CBC Electrolytes Alkaline phosphatase UA, urine culture and cytology US - prostate ```

Answer 20

``` UTI -urethritis -cystitis -prostatitis -pyelonephritis Nephrolithiasis Prostatitis Chlamydia Gonorrhea ``` ``` CBC Electrolytes UA, urine culture and sensitivity BUN/Cr Gram stain and culture of discharge Chlamydia and gonorrhea PCR US - renal CT - abdomen/pelvis ```

Answer 21

``` Stress incontinence Urge incontinence Mixed incontinence Overflow incontinence Functional incontinence UTI DM ``` ``` CBC Electrolytes, glucose BUN/Cr UA, urine culture urodynamic testing IVP Cystourethroscopy ```

Answer 22

``` Pregnancy Anovulatory cycle Polycystic ovarian syndrome Hyperprolactinemia Premature ovarian failure Thyroid disease Pituitary tumor Ovarian or adrenal malignancy Menopause Sheehan's syndrome Anorexia nervosa ``` ``` CBC Electrolytes Urine hCG Pelvic exam US - abdomen/pelvis Prolactin TSH LH/FSH Testosterone MRI - brain ```

Answer 23

``` Dysfunctional uterine bleeding Coagulation disorder Cervical cancer Molar pregnancy Cervical cancer Molar pregnancy Cervical polyp Endometrial hyperplasia Atrophic endometrium Endometrial polyp Cervicitis Atrophic vaginitis Trauma Ectopic pregnancy Ruptured ovarian cyst Ovarian torsion PID Hypothyroidism Spontaneous abortion ``` ``` CBC Electrolytes Urine hCG US abdomen/pelvis Pelvic exam Pap smear cervical culture PT/PTT Colposcopy Hysteroscopy Quantitative serum hCG US - abdomen/pelvis ```

Answer 24

Bacterial vaginosis Candidal vaginitis Trichomonal vaginitis Cervicitis - chlamydia, gonorrhea ``` CBC Electrolytes Pelvic exam Wet mount KOH prep, "whiff test" pH of vaginal fluid Cervical cultures ```

Answer 25

``` Atrophic vaginitis Endometriosis Cervicitis Vaginismus Vulvodynia PID Depression Domestic violence ``` ``` CBC Electrolytes Pelvic exam LH/FSH Wet mount KOH prep Cervical cultures US - pelvis Endometrial biopsy ```

Answer 26

``` Domestic violence Osteogenesis imperfecta Substance abuse Consensual violent sexual behavior Factitious disorder RAPE ``` ``` XR - skeletal survey CT - maxillofacial urine toxicology CBC Electrolytes ``` ``` RAPE Sexual Assault Forensic Evidence collection kit Pelvic exam Urine hCG Wet mount KOH prep Cervical cultures NAAT - chalmydia and gonorrhea Xray skeletal servey HIV antibody Viral hepatitis serologies ```

Answer 27

Carpal tunnel syndrome Median nerve compression in the forearm or arm Radiculopathy of C6 - C7 nerve roots De Quervain's tenosynovitis ``` Phalen's manuever Tinel's sign Finklestein's test Nerve conduction studies EMG ```

Answer 28

Hip fracture Hip dislocation Pelvic fracture ``` X-ray - pelvis/hip CT - hip CBC, type and cross Electrolytes, calcium DEXA scan ```

Answer 29

Osteoarthritis - knee Pseudogout Gout ``` X-ray - knee CBC Electrolytes ESR Uric acid MRI - knee Arthrocentesis and synovial fluid analysis -cell count, gram stain, culture, crystals ```

Answer 30

``` Septic arthritis knee Gout Pseudogout Lyme arthritis Reiter's syndrome Disseminated gonorrhea ``` ``` CBC Electrolytes PT/PTT Arthrocentesis, synovial fluid analysis -cell count, gram stain, culture, crystals Blood cultures x2 UA, urine culture X-ray knee Uric acid Lyme titers ```

Answer 31

Foot pain after exercise Stress fracture Plantar fasciitis Foot sprain X-ray foot MRI - foot Bone scan foot

Answer 32

lateral epicondylitis Stress fracture Cozen's test X-ray - arm Bone scan MRI - elbow

Answer 33

medial epicondylitis Little leaguer's elbow UCL injury X-ray - arm Bone scan MRI - elbow

Answer 34

Peripheral vascular disease Leriche syndrome - aortoiliac occlusive disease Lumbar spinal stenosis Ankle-brachial index Dobbler US of lower extremities Angiography MRI lumbar spine

Answer 35

DVT Baker's cyst rupture Cellulitis ``` CBC Electrolytes, calcium PT/PTT d-dimer Doppler US lower extremities ```

Answer 36

``` Angina MI Tendonitis Bursitis Osteoarthritis ``` ``` ECG CBC X-ray shoulder CXR Echocardiography Stress test ```

Answer 37

Shoulder dislocation Proximal humerus fracture Rotator cuff injury Torn labrum X-ray - shoulder X-ray - arm MRI shoulder

Answer 38

Rhabdomyolysis from statins Polymyositis Inclusion body myositis ``` CBC Electrolytes Phosphate Potassium BUN/Cr Calcium Uric acid CPK Aldolase ALT/AST UA Urine myoglobin ```

Answer 39

``` Constitutional short stature Growth hormone deficiency Hypothyroidism Chronic renal insufficiency Genetic causes Cystic fibrosis ``` ``` Physical exam CBC Electrolytes IGF-1 IGFBP-3 GH stimulation test TSH, fT4 X-ray hand US renal/cardiac Sweat chloride test BUN/Cr Karyotype ```

Answer 40

``` ADHD Oppositional defiant disorder Conduct disorder Manic episode Hyperthyroidism Adjustment disorder Substance abuse Age appropriate behavior ``` ``` Physical exam Mental status exam Urine toxicology TSH EEG ```

Answer 41

Crying or weeks relieved by flatus or eruction - no vomiting, constipation, or fever - no change in appetite, weight, or growth ``` Colic Formula allergy GERD Lactose intolerance Strangulated hernia Testicular torsion ``` Physical eam Rectal exam + stool for occult blood US - abdomen, testicular

Answer 42

``` started in one eye now in both +mucoid discharge +itching +difficulty opening eyes in AM +photophobia ``` ``` Bacterial conjunctivitis Viral conjunctivitis Keratitis Uveitis Seasonal allergies ``` ``` Physical exam Opthalmoscopic exam CBC Electrolytes Discharge cultures Slit lamp exam ```

Answer 43

Abdominal pain, with vomiting, bloody stools Well between episodes ``` Intussusception Appendicitis Meckel's diverticulum Volvus Gastroenteritis Entercolitis Trauma ``` ``` Physical exam Rectal exam + occult blood CBC Electrolytes Contrast enema US abdomen CT abdomen ```

Answer 44

``` Worse in morning better on weekends and holidays Missed school a lot Normal growth and development +/- Emotional trauma Malingering Somatoform disorder IBS Lactose intolerance Child abuse ``` ``` Physical exam CBC Electrolytes US - abdomen CT - abdomen Amylase, lipase Stool exam ```

Answer 45

``` Pyloric stenosis Partial duodenal atresia GERD Gastroenteritis Hepatitis UTI ``` ``` Physical exam CBC Electrolytes US - abdomen Barium swallow pH probe Endoscopy ```

Answer 46

Hirschprung's disease Low fiber diet Anal stenosis Hypothyroidism ``` Physical exam Rectal exam Stool exam culture Barium enema Anorectal manometry Suction rectal biopsy ```

Answer 47

Fever + rash, not immunized ``` Rubella Roseola Fifth disease Varicella Scarlet fever Meningitis ``` ``` Physical exam CBC Viral antibodies/titers Throat swab for cultures CT - head LP - CSF analysis ```

Answer 48

Fever, diarrhea, lethargy, and weakness ``` Viral gastroenteritis Bacterial gastroenteritis Parasitic gastroenteritis Food poisoning UTI URI Volvus Intussception ``` ``` Physical exam Stool exam, culture, parasites and ova CBC Electrolytes UA, urine culture AXR ```

Answer 49

Fever, decreased breast feeding, and lethargy Neonatal sepsis Meningitis Pneumonia Pyelonephritis ``` Physical exam CBC Electrolytes Blood culture x2 LP - CSF analysis CXR UA, urine culture ```

Answer 50

Fever, ear pulling URI Meningitis Pyelonephritis ``` Physical exam with otoscopy CBC Blood culture Tympanocentesis + culture LP + CSF analysis UA, urine culture ```